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2003, 10-27 Permit App: BLD-03-02913 Fireplace, Piping*tine #Valley Mechanical Permit Application 11707, East Sprague Avenue, Suite 106 509-688-0036 - Phone 509-688-0037 - Fax Spokane Valley, WA 99206 METHOD OF PA D CASH D C DESCRIPTION OF WORK 4 O UNITS X PROJECT ((( ADDRESS. ,4 (-/7/ea EQUALS AMOUWF 5T PERMIT USE: OWNER:kiAii tit.c ?...., X fll S CLa.ek:> co) PHONE (Daytime Contact): 60.9_ c..iQc f 7 � MAILING ADDRESS: . q 7 ao .:7 -:g. > 100,000 k/i On176i OA- - 99 ,.-/(a -'S (Street) • (city/state) (ZIP) CONTRACTOR: X 550 • LICENSE t: MAILING ADDRESS:'- . UNLISTED APPLIANCE (ADDrITONAL FEE) > 400,000 X PHONE #: • (street) 5 USED APPLIANCE (WSEC min. AFUE rating) . (city/state) (ZIP) X. 550 • 6 METHOD OF PA D CASH D C DATE: EXPIRES: BANKCARD NUMBER AUTHORIZED SIGNATURE: DESCRIPTION OF WORK 4 O UNITS X COST EQUALS AMOUWF 1 FUEL BURNING APPLIANCE - OR < 100,000 X ' 515 •2 FUEL BURNING APPLIANCE > 100,000 . X ' ' 519 • 3 UNLISTED APPLIANCE (ADDMONAL FEE) - OR <400,000 X 550 • 4. UNLISTED APPLIANCE (ADDrITONAL FEE) > 400,000 X 5100 • 5 USED APPLIANCE (WSEC min. AFUE rating) or <400,000 X. 550 • 6 USED APPLIANCE (WSEC min. AFUE rating) > 400,000 X 5100 • 7 BOILER/REFRIGERATION I- I00M BTU X 515 ' - 8 BOILER/REFRIGERATION 101- 500M BTU X 528 • 9 BOILER/REFRIGERATION 501 - 1,000M BTU X 539 • 10 BOILER/REFRIGERATION 1001- 1,750M BTU X 557 • 11 BOILER/REFRIGERATION +1750M BTU X 595 - 12 GAS LOC, GAS INSERT, GAS FIREPLACE - f X 510 - 13 RANGE - X 510 - 14 DRYER' - X 510 ' - 15 FUEL BURNING WATER HEATER - - X 510 • 16 MLSC FUEL BURNING ADPL..__. - - _- .. _ .: X• - - --510 - ......_- . _.—....__.. 17 GAS PIPING (ea. Outlet) _ X 51 • 18 DUCT SYSTEMS _ X 510 • 19 VENTILATING FANS - - X 510 - 20 AIR HANDLER (DOES NOT include ducting) - OR <10,000CFM X 512 21 AIR HANDLER (DOES NOT include ducting) '10.000 CFM X 519 - 22 EVAPORATIVE COOLERS - - X 510 .• 23 TYPE I HOOD - X 550 • 24 TYPE B HOOD - X 510 • 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X 512 • 26 AIR CONDITIONER 3-15 TON X 520 • 27 ARCONDDIONER 15.30 TON X 525 ' • 28 AIR CONDITIONER 30-50 TON X 535 • 29 AIRCONDMONER +SO TON X 560 • 30 LPC STORAGE TANK - X 510 • 31 WOOD OR PELLET STOVE/INSERT - X ' 510 • 32 WOOD STOVE - FREESTANDING - X 525 • HENT SUBTOTAL: PLUS PROCESSING FEE 535.00 TOTAL PERMIT FEE DUE: DATE: EXPIRES: BANKCARD NUMBER AUTHORIZED SIGNATURE: